High rates of neighborhood out-migration may harm the mental health of black mothers
High rates of neighborhood out-migration may harm the mental health of black mothers

Living in a neighborhood with high eviction rates is associated with higher levels of psychological distress over time among pregnant black women compared to those living in neighborhoods with lower eviction rates, a new study finds.

The study highlights the impact of the housing crisis on pregnant women, even those who have not personally been evicted, and the importance of neighborhood conditions on the health of black mothers, said lead author Shawnita Seeley-Jefferson, associate professor of epidemiology at Ohio State University College of Public Health.

Shawnita Seeley-Jefferson

“Black mothers are at least three times more likely to die during or in the year after pregnancy than white mothers, and we don’t talk enough about the neighborhoods people live in as a predictor of poor maternal mental health,” Seeley -Jefferson I said.

She and her colleagues examined trajectories of neighborhood evictions over time and the odds of moderate and severe psychological distress among more than 800 black women from Metro-Detroit during pregnancy. Higher rates of eviction petitions and court decisions in a woman’s neighborhood before and during pregnancy were associated with two- to four-fold higher odds of psychological distress. The study appears today in American Journal of Epidemiology.

Overall, 68% of the women in the study reported psychological distress during pregnancy, with 8% of them reporting severe psychological distress – the type of health problems that constitute a diagnosed mental illness. Recent estimates show that 3.4% of the US adult population has serious psychological distress.

Mental health conditions, including suicide and substance use disorder-related overdoses, are the leading cause of maternal death.

“It’s stressful, even when you’re not the one being evicted, to see your neighbors’ and friends’ things on the curb—baby beds, toys—and know that they might have nowhere to go and that you might be next. ,” Seeley-Jefferson said.

Estimates in the study inevitably underestimate the true impact of evictions because they don’t account for illegal evictions — those that don’t go through the courts, Seeley-Jefferson said. Previous research has shown that 40-50% of evictions are illegal.

Seeley-Jefferson, a Detroit native who has studied the impact of neighborhoods on fertility and motherhood for black women for more than a decade, said the results confirm what her observations have been telling her for years: “Neighborhoods matter. No one has linked these violent experiences over time with poor maternal mental health. A lot of the discourse is, “Black people have a higher rate of everything, what are these people doing wrong that increases their risk?” But what we’re showing is that the problem is literally the way this society is organized.

“Neighborhoods disproportionately burdened by eviction rates stem from historic federally sponsored red-lining as well as contemporary racism and sexism.”

The red line refers to systemic disinvestment in predominantly black neighborhoods.

Beyond policy changes that protect tenants and increase funding for affordable housing, a logical next step is to identify modifiable risk factors for psychological distress during pregnancy so that social and health care providers can use cultural appropriate and appropriate harm reduction interventions, Sealy,” Jefferson said.

“The root cause of black maternal health disparities must be recognized and addressed or these disparities will continue to worsen over time,” she said.

The study was co-authored by Benita Jackson of Smith College and Britney Francis of Harvard.

Support for this research was provided by the Robert Wood Johnson Foundation.

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